Lex W Doyle1, Sarath Ranganathan2, Anjali Haikerwal3, Jeanie L Y Cheong4. 1. Neonatal Services, Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia. Electronic address: lwd@unimelb.edu.au. 2. Department of Paediatrics, University of Melbourne, Melbourne, Australia; Respiratory Medicine, Royal Children's Hospital, Melbourne, Australia. 3. Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia. 4. Neonatal Services, Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
Abstract
OBJECTIVES: To assess whether preeclampsia was associated with expiratory airflow at school-age in children born either extremely preterm (<28 weeks of gestation) or extremely low birthweight (ELBW; <1000 g birth weight). STUDY DESIGN: Participants comprised 3 cohorts of children born extremely preterm/ELBW in the state of Victoria, Australia, in 1991-1992, 1997, or 2005. Expiratory airflows were measured at age 8 years, and results converted to z scores. Data were compared between those exposed to preeclampsia with those unexposed to preeclampsia; analyses were then adjusted for confounding perinatal variables. Analyses were repeated within subgroups of extremely preterm only and ELBW only. RESULTS: Respiratory data were available for 544 of 717 (76%) survivors, of whom 95 (17%) had been exposed to preeclampsia. On univariable analysis, those exposed to preeclampsia had better z scores for flows for the forced expired volume in 1 second (zFEV1) (mean difference 0.29, 95% CI 0.04-0.53; P = .022) and zFEV1/forced vital capacity (mean difference 0.33, 95% CI 0.04-0.61; P = .025); the difference persisted for zFEV1 after adjustment for confounding perinatal variables. Analyses confined to those born extremely preterm revealed little evidence for associations between preeclampsia and airflow. In analyses confined to those born ELBW, preeclampsia was associated with better zFEV1, which persisted after adjustment (mean difference 0.33, 95% CI 0.04-0.63; P = .025). CONCLUSIONS: Exposure to maternal preeclampsia was not associated with worse expiratory airflow in children born extremely preterm/ELBW; in fact, some airflows were better.
OBJECTIVES: To assess whether preeclampsia was associated with expiratory airflow at school-age in children born either extremely preterm (<28 weeks of gestation) or extremely low birthweight (ELBW; <1000 g birth weight). STUDY DESIGN:Participants comprised 3 cohorts of children born extremely preterm/ELBW in the state of Victoria, Australia, in 1991-1992, 1997, or 2005. Expiratory airflows were measured at age 8 years, and results converted to z scores. Data were compared between those exposed to preeclampsia with those unexposed to preeclampsia; analyses were then adjusted for confounding perinatal variables. Analyses were repeated within subgroups of extremely preterm only and ELBW only. RESULTS: Respiratory data were available for 544 of 717 (76%) survivors, of whom 95 (17%) had been exposed to preeclampsia. On univariable analysis, those exposed to preeclampsia had better z scores for flows for the forced expired volume in 1 second (zFEV1) (mean difference 0.29, 95% CI 0.04-0.53; P = .022) and zFEV1/forced vital capacity (mean difference 0.33, 95% CI 0.04-0.61; P = .025); the difference persisted for zFEV1 after adjustment for confounding perinatal variables. Analyses confined to those born extremely preterm revealed little evidence for associations between preeclampsia and airflow. In analyses confined to those born ELBW, preeclampsia was associated with better zFEV1, which persisted after adjustment (mean difference 0.33, 95% CI 0.04-0.63; P = .025). CONCLUSIONS: Exposure to maternal preeclampsia was not associated with worse expiratory airflow in children born extremely preterm/ELBW; in fact, some airflows were better.
Authors: Clement L Ren; James E Slaven; David M Haas; Laura S Haneline; Christina Tiller; Graham Hogg; Jeffrey Bjerregaard; Robert S Tepper Journal: Pediatr Pulmonol Date: 2022-07-14